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Cited by 124Intestinal and Peritoneal AdhesionsSurgical Sutures and AdhesivesHernia repair and management

Prevention strategies of postoperative adhesion in soft tissues by applying biomaterials: Based on the mechanisms of occurrence and development of adhesions

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Liao, Jie, Li, Xiaoming, Fan, Yubo·2023·Bioactive Materials
DOI 10.1016/j.bioactmat.2023.02.026PMC PMC10030827
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Abstract

Postoperative adhesion (POA) widely occurs in soft tissues and usually leads to chronic pain, dysfunction of adjacent organs and some acute complications, seriously reducing patients' quality of life and even being life-threatening. Except for adhesiolysis, there are few effective methods to release existing adhesion. However, it requires a second operation and inpatient care and usually triggers recurrent adhesion in a great incidence. Hence, preventing POA formation has been regarded as the most effective clinical strategy. Biomaterials have attracted great attention in preventing POA because they can act as both barriers and drug carriers. Nevertheless, even though much reported research has been demonstrated their efficacy on POA inhibition to a certain extent, thoroughly preventing POA formation is still challenging. Meanwhile, most biomaterials for POA prevention were designed based on limited experiences, not a solid theoretical basis, showing blindness. Hence, we aimed to provide guidance for designing anti-adhesion materials applied in different soft tissues based on the mechanisms of POA occurrence and development. We first classified the postoperative adhesions into four categories according to the different components of diverse adhesion tissues, and named them as "membranous adhesion", "vascular adhesion", "adhesive adhesion" and "scarred adhesion", respectively. Then, the process of the occurrence and development of POA were analyzed, and the main influencing factors in different stages were clarified. Further, we proposed seven strategies for POA prevention by using biomaterials according to these influencing factors. Meanwhile, the relevant practices were summarized according to the corresponding strategies and the future perspectives were analyzed.

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  • One primary goal of anti-adhesion materials is to avoid fibrin bridges forming, as these bridges serve as precursors to adhesions by providing a scaffold for fibroblast proliferation and collagen deposition.

    “One of the primary goals of these materials is to avoid fibrin bridges forming, as these bridges serve as precursors to adhesions by providing a scaffold for fibroblast proliferation and collagen deposition [15].”

    From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [15]

  • HA inhibits fibroblast proliferation and fibrin deposition, which are key factors in adhesion development.

    “HA also inhibits fibroblast proliferation and fibrin deposition, which are key factors in adhesion development [15].”

    From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [15]

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Authors
Liao, J., Li, X., & Fan, Y.
Affiliations
Beihang University (CN)
Corresponding author
  • Li, Xiaoming
  • Fan, Yubo
ORCID
Venue
Bioactive Materials
Publisher
Elsevier BV
Published
2023-08
Volume
26
Pages
387-412
ISSN
  • 2097-1192 (ISSN-L)
  • 2452-199X
DOI
10.1016/j.bioactmat.2023.02.026
PMC
PMC10030827
OpenAlex
W4327732363
Cited by
124
References
6
Citations by year
2026: 19 · 2025: 48 · 2024: 51 · 2023: 6
FWCI
7.54
Type
journal article
Language
en
Open access
Licence
Locations
  • Bioactive Materials (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Higher Education Discipline Innovation Project (B13003)
  • Fok Ying Tung Education Foundation
  • National Natural Science Foundation of China (32171345, 11827803, U20A20390, T2288101)
  • Ministry of Science and Technology of the People's Republic of China
  • Academic Excellence Foundation of BUAA for PHD Students
Topics
  • Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
  • Health Sciences › Medicine › Surgery › Surgical Sutures and Adhesives
  • Health Sciences › Medicine › Surgery › Hernia repair and management
Keywords
postoperative adhesions, soft tissue adhesion, adhesion prevention, adhesion mechanism, vascular adhesion, adhesive adhesion, drug delivery, barrier materials, adhesion recurrence

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